Thanks, Anti-Vaxxers. You Just Brought Back Measles in NYC.

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"There is currently an outbreak of measles in New York City. Considered eliminated in the United States in 2000, last year saw a record number ofoutbreaks around the country. It's only three months into 2014, and not only is the nation's largest city seeing cases in several boroughs, butother major metropolitan areas are warning of new cases as well.
This is not some inconvenience to be laughed off. Measles is a highly-contagious illness caused by a virus. It usually presents with a combination of rash, fevers, cough and runny nose, as well as characteristic spots in the mouth. Most patients recover after an unpleasant but relatively uneventful period of sickness. Unfortunately, about one patient in every 1,000 develops inflammation of the brain, and one to three cases per 1000 in the United States result in death." http://www.thedailybeast.com/article...es-in-nyc.html

While I agree that those with the anti-vaccine mentality risks the spread of the disease. They are NOT the cause. Immunization is important but to single out one population(anti-vaccine) does not point the finger firmly in one direction or another. It is important to note that illegal immigration and immunization status is an equally dominant factor. As well as our ever increasing mobility to un-vaccinated populated areas of the world.

While the US did consider itself measles free...there remained measles cases.

In 2000, the United States achieved measles elimination(defined as interruption of year-round endemic measles transmission) (1). However, importations of measles into the United States continue to occur, posing risks for measles outbreaks and sustained measles transmission.

During 2011, a total of 222 measles cases (incidence rate: 0.7 per 1 million population) and 17 measles outbreaks (defined as three or more cases linked in time or place) were reported to CDC, compared with a median of 60 (range: 37–140) cases and four (range: 2–10) outbreaks reported annually during 2001–2010.

This report updates an earlier report on measles in the United States during the first 5 months of 2011 (2). Of the 222 cases, 112 (50%) were associated with 17 outbreaks, and 200 (90%) were associated with importations from other countries, including 52 (26%) cases in U.S. residents returning from abroad and 20 (10%) cases in foreign visitors.

Other cases associated with importations included 67 (34%) linked epidemiologically to importations, 39 (20%) with virologic evidence suggesting recent importation, and 22 (11%) linked to cases with virologic evidence of recent importation.Most patients (86%) were unvaccinated or had unknown vaccination status. The increased numbers of outbreaks and measles importations into the United States underscore the ongoing risk for measles among unvaccinated persons and the importance of vaccination against measles (3).

That is true, but that is the importance of herd immunity. Where we were seeing small outbreaks of immunization preventable diseases that were easily contained we are now seeing larger outbreaks that are mainly d/t the anti-vaccine movements.

While I agree that those with the anti-vaccine mentality risks the spread of the disease. They are NOT the cause. Immunization is important but to single out one population(anti-vaccine) does not point the finger firmly in one direction or another.

The individuals that do not vaccinate significantly increase the available vectors for transmission of the disease; I don't think anyone can honestly argue that fact. We can't realistically prevent the virus from being imported, and we can't realistically correct individuals that don't seroconvert, so doesn't that leave an avenue to target for reduction of risk in the unvaccinated?

I give no argument that vaccination is important and we will see an increase of more widespread epidemics that will put more of the population at risk. That is not what the CDC has so far documented. The majority of these outbreaks are imported right now which will put the un-vaccinated population at risk. How do we enforce vaccination amongst illegal and untraceable immigrants bringing disease?

The title "Thanks, Anti-Vaxxers. You Just Brought Back Measles in NYC." implies they are the reason for the current issues. While this puts them at significant risk of getting measles and causing a wider spread of the disease...they are not the reason for the NYC nor the MA outbreaks. I believe anti-vaxxers say this as measles isn't (wasn't) prevalent in the US they tout vaccinations aren't necessary.

It is the imported un-vaccinated bringing it to the forefront. Which of course now places their children at risk.

Measles elimination has been maintained in the United States for more than a decade through high population immunity secondary to high MMR vaccination coverage. Coverage with 1 dose has been >90% among children aged 19–35 months since 1996. The increase in measles importations and outbreaks during 2011 serves as a reminder that measles remains endemic in many parts of the world and unvaccinated U.S. residents continue to place themselves and others in their communities at risk for measles and its complications.

The increase in importations reflects recent increases in the incidence of measles in countries visited by U.S. travelers. The source of almost half of the measles importations in 2011 was the WHO European Region, which reported >30,000 cases of measles, including 27 cases of measles encephalitis, a complication that often results in permanent neurologic sequelae, and eight measles-related deaths in 2011. Five countries (France, Italy, Romania, Spain, and Germany) accounted for more than 90% of cases reported to the European Centers for Disease Prevention and Control (4). Although measles has been eliminated in the Region of the Americas since 2002 and considerable progress has been achieved in global measles control, measles is still common in many countries. Importations of measles virus into the United States will likely continue and cause outbreaks in communities that have clusters of unvaccinated persons. Maintenance of high MMR vaccination coverage is essential to prevent measles outbreaks and sustain measles elimination in the United States. Despite the relatively small number of reported cases in the United States, the public and the health-care providers must remain vigilant. A drop in MMR vaccination coverage in a community can increase the risk for large, sustained measles outbreaks, as experienced recently in Canada and France (4,5), or reestablishment of endemic transmission, as experienced in the United Kingdom (6).

Occasionally, measles cases are reported without apparent links to importations, but virologic evidence suggests recent importation of an undetected case or chain of cases. Given travel patterns, the highly infectious nature of measles virus, and limitations of surveillance systems, not every importation of measles virus into the United States is detected. Therefore, collection of samples for virus detection is extremely important. Genetic characterization of viruses can help to confirm or suggest the likely source of imported viruses because measles genotypes are distributed heterogeneously in regions that have not yet eliminated measles (7,8).

Health-care providers play an important role in maintaining elimination of measles in the United States. Patients with measles frequently seek medical care; therefore, health-care providers should maintain a high awareness of measles and suspect measles in persons who have a febrile rash illness and clinically compatible symptoms (e.g., cough, coryza, or conjunctivitis) and who recently have traveled abroad or have had contact with travelers. Providers should implement isolation precautions immediately and promptly report suspected measles cases to their local health department to limit spread to other susceptible persons, including those who cannot be vaccinated because of medical contraindications or those too young for vaccination. In several outbreaks during 2011, despite seeking medical care, the source case was not identified until after the first or second generation of cases was reported.

Misdiagnosis and delayed reporting resulted in missed opportunities to prevent additional cases because of delayed implementation of control measures. Nevertheless, for most cases, early reporting by providers and rapid control efforts by state and local public health agencies have prevented measles transmission and limited the size of outbreaks.

I give no argument that vaccination is important and we will see an increase of more widespread epidemics that will put more of the population at risk. That is not what the CDC has so far documented. The majority of these outbreaks are imported right now which will put the un-vaccinated population at risk. How do we enforce vaccination amongst illegal and untraceable immigrants bringing disease?

We cannot close off our borders and restrict U.S. citizens from entering or leaving the U.S.. Most vaccine preventable diseases were eliminated from this country due to widespread vaccination. The reason these diseases are making a come back is due to low vaccine rates. Measles vaccination rates need to be around 95% to prevent a major outbreak. There are many places in U.S. that have fallen well below those rates. This is what herd immunity is all about.

[FONT=sl-ApresRegular]Falling vaccination rates are now an urgent concern in public health. Measles incidence dropped 99 percent after the vaccine was introduced in 1963. Between 2000 and 2007, the United States saw an average of just 63 measles cases per year, and almost all of those victims brought the disease into the United States from abroad. In 2013, however, the incidence of measles tripled[FONT=sl-ApresRegular]. Unlike in previous years, the majority of the victims contracted the disease here in the United States, meaning that measles outbreaks are now a serious national problem. It could get worse. Vaccination rates in the United States remain at about 90 percent[FONT=sl-ApresRegular], but in the United Kingdom, where vaccination has fallen below 80 percent, the disease is once again endemic[FONT=sl-ApresRegular].

The majority of these outbreaks are imported right now which will put the un-vaccinated population at risk. How do we enforce vaccination amongst illegal and untraceable immigrants bringing disease?

The initial virus is imported. This imported virus now contacts more susceptible vectors because of the increase in unvaccinated individuals and we have an outbreak. We target what we can, reducing the number of vectors by increasing vaccination rates.

People infected abroad continue to spark outbreaks among pockets of unvaccinated people, including infants and young children. It is still a serious illness: 1 in 5 children with measles is hospitalized. Usually there are about 60 cases per year, but 2013 saw a spike in American communities – some 175 cases and counting – virtually all linked to people who brought the infection home after foreign travel.
“A measles outbreak anywhere is a risk everywhere,” said CDC Director Tom Frieden, M.D., M.P.H. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day. Someday, it won’t be only measles at the international arrival gate; so, detecting diseases before they arrive is a wise investment in U.S. health security.
Eliminating measles worldwide has benefits beyond the lives saved each year. Actions taken to stop measles can also help us stop other diseases in their tracks. CDC and its partners are building a global health security infrastructure that can be scaled up to deal with multiple emerging health threats.

Is the patient's fault in hospital room 101 that caused all the nosocomial infections that spread to all the rooms on the same floor or the healthcare staff that didn't wash their hands? That is essentially what you are trying to argue.
The initial carrier may or may not have been from NYC, but it is the lack of vaccination rates (directly attributable to the anti-vaccine movement) that is the cause of the measles outbreak to be widespread in NYC.

I just read another article today about another famous person not vaccinating her children because she thinks they will get autism. The sad fact is that in our society people look up to celebrities more than scientists and doctors. And until we can get the celebrities educated and not spread misinformation the situation is just going to get worse until our population falls below the 85%. Then the really awful diseases will come back into this country and we will have epidemics like there were in 1915 and millions of people will die. It makes me sad that so many people with power in this country are misinformed.

I'm not sure there has been anything pointing to what exactly is the cause of the measles outbreak in the Bronx and Washington Heights. However it is known that at least two of the cases involving children were due to parents refusing to vaccinate.